Accuracy of p57^KIP2 compared with genotyping to diagnose complete hydatidiform mole: a systematic review and meta‐analysis

Abstract

BackgroundDistinguishing hydatidiform moles (HMs) from nonmolar specimens and the subclassification of HM are important because complete hydatidiform mole (CHM) is associated with an increased risk of development of gestational trophoblastic neoplasia. However, diagnosis based solely on morphology has poor inter‐observer reproducibility. Recent studies have demonstrated that the use of p57KIP 2 immunostaining improves diagnostic accuracy for CHM.ObjectivesTo evaluate the accuracy of p57KIP 2 immunostaining compared with molecular genotyping for the diagnosis of CHM.Search strategyMajor databases were searched from inception to March 2017 using the terms ‘hydatidiform mole’, ‘p57’, and ‘genotyping’, with their variations, and the search limit for the relevant study design.Selection criteriaAny cross‐sectional study, case series, case–control study, cohort study, or clinical trial that evaluated the accuracy of p57KIP 2 immunostaining for the diagnosis of CHM compared with genotyping was included. Case reports, narrative reviews, expert opinions, and animal testing were excluded.Data collection and analysisExtracted accuracy data were tabulated and pooled using a hierarchical bivariate random effects model.Main resultsBivariate meta‐analysis produced a summary sensitivity of 0.984 (95% CI: 0.916–1.000) and specificity of 0.625 (95% CI: 0.503–0.736) with significant heterogeneity for specificity (I 2 = 71.8, chi‐square P = 0.029). The pooled summary diagnostic odds ratio was 56.54 (95% CI: 11.03–289.74) with no heterogeneity (I 2 = 0.00%, chi‐square P = 0.67). The diagnostic performance of the test was high with an area under the curve of (AUC) 0.980.Conclusionsp57KIP 2 immunostaining is accurate when diagnosing CHM. It can be used as an adjunct test in a combination algorithmic approach.Tweetable abstractA meta‐analysis to evaluate the accuracy of p57KIP 2 compared with genotyping to diagnose CHM.

Expression of p57 immunomarker in the classification and differential diagnosis of partial and complete hydatidiform moles

“…They found mean maternal age in the CM group was 24.7 years and in the PM group was 26.9 years, with no significant differences among these two groups ( P = 0.27). [4]…”

Dysregulation of Placental Functions and Immune Pathways in Complete Hydatidiform Moles

“…To validate the histological diagnosis of CHM, we conducted immunostaining for p57, which is expressed from a paternally imprinted gene and is a recognized diagnostic marker in CHM [12,98,99]. To validate RNA level findings at the protein level for one down-regulated gene, five-µm-thick sections were cut from each TMA onto adhesive glass slides (SuperFrost Ultra Plus, TS Labor, Budapest, Hungary), and immunostained for p57 and galectin-14 using antibodies and conditions listed in Table 10.…”

Influence of COVID‐19 pandemic on molar pregnancy and postmolar gestational trophoblastic neoplasia: An observational study

“…Table S4 presents the studied variables and, where appropriate, the criteria for diagnosing variables. 20,[22][23][24] Additionally, Table S4 reviews databases that were used in calculating MP and postmolar GTN incidence.…”